Canada: Week 35 is the first week of the 2004-2005 FluWatch and Respiratory Virus Detections season in Canada .  Increased activity, including outbreaks have been reported for weeks 34-36 in eastern Ontario . Elsewhere in the country influenza-like illness rates are very low, only British Columbia has reported recent sporadic detections of influenza, (see map). During the week ending September 4 (week 36), sentinel physicians reported 3 cases of influenza-like illness (ILI) per 1000 patient visits, (see ILI graph) (Note: Not all provinces and territories contribute to the calculation of the weekly ILI rate during the summer season). Over the two week period from August 22 to September 4, Health Canada received 902 reports of laboratory tests for influenza, including 2 (0.2%) influenza A detections (in British Columbia ) and no influenza B detections (see table below).

Eastern Ontario LTCF outbreaks: As of September 10, 2004 , four outbreaks of laboratory confirmed influenza have been reported in Ottawa area LTCFs in recent weeks. All four outbreaks have been confirmed as influenza A by rapid antigen testing. Strain characterization of the virus associated with the first outbreak has identified the strain as A/Fujian/411/02(H3N2)-like virus, which has been detected sporadically throughout the summer and circulated widely around the world during the 2003-2004 season. A/Fujian/411/02(H3N2)-like virus is the WHO recommended H3N2 component of 2004-2005 northern hemisphere vaccine. Subtyping and strain characterization are pending for the latter three outbreaks.

Avian Influenza: In the past two weeks, WHO has reported two more cases (both fatal) of human infection with avian influenza A (H5N1); one death was confirmed in an 18-year-old male from Thailand , who had been exposed to sick chickens. The second case was an informal report of a laboratory-confirmed fatal case in a child from Viet Nam , for a total of four human cases of H5N1 in Viet Nam since August. Since January 2004, a total of 39 human cases, including 28 fatalities, have been reported from Viet Nam and Thailand , amidst recurring outbreaks of avian influenza in several Asian countries. See

• WHO latest updates

United States: CDC: The final report of the 2003-2004 season was published for the week ending May 22, 2004 (week 20). Surveillance will resume on October 15, 2004 .

• CDC Weekly Report

International: As of September 7, 2004 , WHO reported low levels of influenza activity for most parts of the world, with the exception of Hong Kong SAR where influenza A(H3N2) activity is occurring and parts of Australia where localized outbreaks have been reported. New Zealand is also reporting increased influenza A activity, associated with A/Fujian/411/02(H3N2)-like viruses.

• WHO Global Atlas
• Australia 
• NewZealand

Total number of influenza tests performed and number of positive tests by province/territory of testing laboratory, Canada, 2004-2005

Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.

Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.

Abbreviations: Newfoundland/Labrador (NL), Prince Edward Island (PE), New Brunswick (NB), Nova Scotia (NS), Quebec (QC), Ontario (ON), Manitoba (MB), Saskatchewan (SK), Alberta (AB), British Columbia (BC), Yukon (YT), Northwest Territories (NT), Nunavut (NU)

Respiratory virus laboratory detections in Canada, by geographic regions, are available weekly on the following website:
<http://www.phac-aspc.gc.ca/bid-bmi/dsd-dsm/rvdi-divr/index.html>

Number of influenza surveillance regions† reporting widespread or localized influenza activity, Canada, by report week, 2004-2005 (N=52)

† sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Influenza Activity Level by Provincial and Territorial Influenza Surveillance Regions, Canada, August 29 to September 4 (Week 36)
	No Data No Activity Sporadic Activity Localized Activity Widespread Activity
Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and outbreaks. Please refer to detailed definitions for the 2004-2005 season. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website. Select single maps by report week to get this updated information. <http://dsol-smed.phac-aspc.gc.ca/dsol-smed/fluwatch/fluwatch.phtml?lang=e> Click on the map to view provinces/territories and maps for other weeks.

Influenza tests reported and percentage of tests positive, Canada, by report week, 2004-2005

Percent positive influenza tests, compared to other respiratory viruses by reporting week, Canada, 2004-2005

Influenza strain characterization, Canada, cumulative, 2004-2005 influenza season by the Respiratory Viruses Section at the National Microbiology Laboratory
[N=0]

NACI recommended components of the 2004-2005 Canadian vaccine: A/New Caledonia/20/99 (H1N1)-like virus, , A/Fujian411/2002 (H3N2)-like virus and either B/Hong Kong/330/2001-like or B/Shangdong/7/97-like virus. Note: the influenza A(H1N2) virus strain is a reassortment virus derived from the influenza A (H1N1) and A(H3N2) virus strains. This H1N2 strain circulated widely during the 2001-2002 season and the current vaccine is expected to provide protection against this virus as well as providing good protection against A/Panama/2007/99(H3N2)-like viruses and some cross protection against the new A/Fujian/411/2002(H3N2)-like virus. However, the recently identified B/Sichuan/379/99-like viruses (B component of the 2001-2002 influenza vaccine) belong to a different lineage (B Yamagata lineage) than the B/Hong Kong/330/2001-like viruses included in this year's vaccine.

Influenza-like illness (ILI) reporting rates, Canada, by report week, 2004-2005 compared to 1996/97 through 2003/2004 seasons

Note: No data available for mean rate in previous years for weeks 21 to 39 (1996-1997 through 2002-2003 seasons). During weeks 20-39, 2002-2003/ 2004-2005 seasons, ILI is reported once every two weeks, on even weeks only

Number of Outbreaks in Long Term Care Facilities by Report Week, Canada, 2004-2005

Please note that the above graphs may change as late returns come in.

Definitions for the 2004-2005 season

[FluWatch]